Introduction: The ptosis is a fall of the upper eyelid in relation to a deficit of the levator device of this one. In practice, it poses two major problems, the first one is the eminent risk of amblyopia during severe...Introduction: The ptosis is a fall of the upper eyelid in relation to a deficit of the levator device of this one. In practice, it poses two major problems, the first one is the eminent risk of amblyopia during severe congenital ptosis, and the second is of an aesthetic nature, representing the main reason for consultation. The aim of this work is to evaluate the interest of the levator palpebrae superioris muscle plication in the ptosis surgery. Materials and Methods: We collected 12 patients who received a correction of their ptosis by plication of the levator palpebrae superioris muscle over a period of 3 years from January 2012 to December 2014. Result: The mean age at treatment was 22 years;the ptosis was congenital in 8 cases, and acquired in 4. The ptosis was major in 67% and moderate in 33% of the cases. Muscle plication was the basic surgical technique in all patients in our series. The function and aesthetic results were satisfying in 6 cases (50%), good in 4 cases (34%), acceptable in 1 case and bad in 1 case (8%). Discussion: The comparative study has shown that the plication of the levator palpebrae superioris muscle is a possible alternative for the correction of ptosis whatever the type of ptosis with results comparable to the reference technique compared to the degree of correction, whereas the operative follow-up is simpler and more minor complications. Conclusion: The surgical treatment of ptosis should be done after a systematic clinical examination and after very precise indications. However, the plication of the levator muscle of the upper eyelid has shown its functional and aesthetic efficiency in congenital ptosis and in the ptosis of the adult.展开更多
Background Accurate preoperative evaluation of the levator palpebrae superioris(LPS)strength is required for specific calculation of anterior migration or shortening.This information serves as a surgical reference for...Background Accurate preoperative evaluation of the levator palpebrae superioris(LPS)strength is required for specific calculation of anterior migration or shortening.This information serves as a surgical reference for more accurate correction of ptosis.Methods Between June 2017 and June 2019,155 eyes of 97 patients were studied.Patients were divided into the following 3 groups based on the ptosis degree:mild(28 cases),moderate(53 cases),and severe(16 cases).The LPS strength was evaluated preoperatively and used to calculate LPS anterior migration and shortening.The LPS aponeurosis and Müller’s muscle(L-M)complex was separated from the upper margin of the tarsal plate to the calculated height according to the levator muscle suspension system retention approach.The complex was subsequently fixed to the planned tarsal plate location.The upper eyelid margin(UEM)height,eyelid morphology,eyelid closure,eye symmetry,exposure keratitis status,and patient satisfaction were evaluated at 1 week and at 1 and 6 months postoperatively.Results In all cases,the UEM positions were normal,and only patients with severe ptosis exhibited lagophthalmos in the early posterative period.Six months postoperatively,13%of eyes in the severe group had residual ptosis;all mild and moderate cases exhibited good surgical outcomes.The eyelids closed well with no exposure keratitis.All patients were satisfied with the eyelid contour.Conclusions Accurate LPS anterior migration and aponeurosis shortening can eliminate various factors affecting surgical blepharoptosis treatment.These procedures not only reduce operation time but also enhance the stability of postoperative correction.展开更多
Background:Upper eyelid retraction is a challenging complication of cosmetic upper eyelid blepharoplasty.To avoid extra trauma,we developed a new technique for correcting iatrogenic upper eyelid retraction by postmigr...Background:Upper eyelid retraction is a challenging complication of cosmetic upper eyelid blepharoplasty.To avoid extra trauma,we developed a new technique for correcting iatrogenic upper eyelid retraction by postmigrating a compound flap of the orbicularis muscle and fascia(OFC)on the anterior surface of the tarsal plate.This method extends the aponeurosis of the levator palpebrae superioris muscle(LPS),which can achieve a good correction for post-blepharoplasty retraction.Methods:We collected data from 15 patients with mild to moderate iatrogenic upper eyelid retraction who were treated at our hospital between February 2017 and December 2019.The OFC was used to replace the missing part of the LPS,and post-migration of the LPS and fixation of the OFC to the tarsal margin were conducted.Postoperative outcome measurements included postoperative binocular symmetry,double eyelid smoothness,eyelid fullness,margin reflex distance(MRD1),degree of eyelid closure,and exposure keratitis.The patients were followed-up at seven days,one month,and six months postoperatively.Results:One patient with moderate eyelid retraction showed undercorrection 6 months postoperatively,with the upper eyelid margin located at the upper edge of the pupil.The remaining patients had the upper eyelid margin stabilized at 1.0–2.0 mm below the upper corneal margin.Other observational indicators were satisfactory,including binocular symmetry,double eyelid fluency,and eyelid fullness.During the follow-up,no exposure keratitis was identified.The MRD1 indexes after the operation were significantly different(P<0.001)from those before the procedure.Conclusions:Extension and post-migration of the LPS using the orbicularis muscle and OFC structure can effectively correct mild iatrogenic eyelid retraction after ptosis with less damage and good postoperative eyelid morphology and closure function.展开更多
文摘Introduction: The ptosis is a fall of the upper eyelid in relation to a deficit of the levator device of this one. In practice, it poses two major problems, the first one is the eminent risk of amblyopia during severe congenital ptosis, and the second is of an aesthetic nature, representing the main reason for consultation. The aim of this work is to evaluate the interest of the levator palpebrae superioris muscle plication in the ptosis surgery. Materials and Methods: We collected 12 patients who received a correction of their ptosis by plication of the levator palpebrae superioris muscle over a period of 3 years from January 2012 to December 2014. Result: The mean age at treatment was 22 years;the ptosis was congenital in 8 cases, and acquired in 4. The ptosis was major in 67% and moderate in 33% of the cases. Muscle plication was the basic surgical technique in all patients in our series. The function and aesthetic results were satisfying in 6 cases (50%), good in 4 cases (34%), acceptable in 1 case and bad in 1 case (8%). Discussion: The comparative study has shown that the plication of the levator palpebrae superioris muscle is a possible alternative for the correction of ptosis whatever the type of ptosis with results comparable to the reference technique compared to the degree of correction, whereas the operative follow-up is simpler and more minor complications. Conclusion: The surgical treatment of ptosis should be done after a systematic clinical examination and after very precise indications. However, the plication of the levator muscle of the upper eyelid has shown its functional and aesthetic efficiency in congenital ptosis and in the ptosis of the adult.
文摘Background Accurate preoperative evaluation of the levator palpebrae superioris(LPS)strength is required for specific calculation of anterior migration or shortening.This information serves as a surgical reference for more accurate correction of ptosis.Methods Between June 2017 and June 2019,155 eyes of 97 patients were studied.Patients were divided into the following 3 groups based on the ptosis degree:mild(28 cases),moderate(53 cases),and severe(16 cases).The LPS strength was evaluated preoperatively and used to calculate LPS anterior migration and shortening.The LPS aponeurosis and Müller’s muscle(L-M)complex was separated from the upper margin of the tarsal plate to the calculated height according to the levator muscle suspension system retention approach.The complex was subsequently fixed to the planned tarsal plate location.The upper eyelid margin(UEM)height,eyelid morphology,eyelid closure,eye symmetry,exposure keratitis status,and patient satisfaction were evaluated at 1 week and at 1 and 6 months postoperatively.Results In all cases,the UEM positions were normal,and only patients with severe ptosis exhibited lagophthalmos in the early posterative period.Six months postoperatively,13%of eyes in the severe group had residual ptosis;all mild and moderate cases exhibited good surgical outcomes.The eyelids closed well with no exposure keratitis.All patients were satisfied with the eyelid contour.Conclusions Accurate LPS anterior migration and aponeurosis shortening can eliminate various factors affecting surgical blepharoptosis treatment.These procedures not only reduce operation time but also enhance the stability of postoperative correction.
文摘Background:Upper eyelid retraction is a challenging complication of cosmetic upper eyelid blepharoplasty.To avoid extra trauma,we developed a new technique for correcting iatrogenic upper eyelid retraction by postmigrating a compound flap of the orbicularis muscle and fascia(OFC)on the anterior surface of the tarsal plate.This method extends the aponeurosis of the levator palpebrae superioris muscle(LPS),which can achieve a good correction for post-blepharoplasty retraction.Methods:We collected data from 15 patients with mild to moderate iatrogenic upper eyelid retraction who were treated at our hospital between February 2017 and December 2019.The OFC was used to replace the missing part of the LPS,and post-migration of the LPS and fixation of the OFC to the tarsal margin were conducted.Postoperative outcome measurements included postoperative binocular symmetry,double eyelid smoothness,eyelid fullness,margin reflex distance(MRD1),degree of eyelid closure,and exposure keratitis.The patients were followed-up at seven days,one month,and six months postoperatively.Results:One patient with moderate eyelid retraction showed undercorrection 6 months postoperatively,with the upper eyelid margin located at the upper edge of the pupil.The remaining patients had the upper eyelid margin stabilized at 1.0–2.0 mm below the upper corneal margin.Other observational indicators were satisfactory,including binocular symmetry,double eyelid fluency,and eyelid fullness.During the follow-up,no exposure keratitis was identified.The MRD1 indexes after the operation were significantly different(P<0.001)from those before the procedure.Conclusions:Extension and post-migration of the LPS using the orbicularis muscle and OFC structure can effectively correct mild iatrogenic eyelid retraction after ptosis with less damage and good postoperative eyelid morphology and closure function.
